Elaborating on CGRP monoclonal antibodies, Dr. Aurora explained that they have been shown to inhibit neurogenic vasodilation and are characterized by a long duration of action. She described advantages to this area of research, specifically that monoclonal antibodies can be used as a chronic treatment with no detectable effects on heart rate or blood pressure. Several monoclonal antibodies currently in development include Amgen’s AMG 334; Alder Biopharmaceuticals’ ALD 403; and Arteaus Therapeutics, Labrys/Teva, and Eli Lilly’s LY2951742.
Although it is likely to be a few years before the CGRP monoclonal antibody agents are approved, the panel members agreed that the fact that they are being studied represents an exciting era ahead for clinicians treating patients with migraine. Currently, patients are treated with a range of therapies from blood pressure agents to epilepsy medications. Discussing these options with patients also opens the door for communicating about how their current treatments are working and what may be on the horizon for them in the future.
Dr. Lipton encouraged clinicians in attendance to visit these websites for additional resources and information: www.AmericanHeadacheSociety.org ; www.AmericanMigraineFoundation.org ; and www.EaseHeadacheMigraine.com .
2. Lipton RB, Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68:343-349.
3. Dodick DW, Turkel CC, DeGryse RE, et al. OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMT clinical program. Headache. 2010;50(6):921-936.